G9862 HCPCS Level II code: Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic…

G9862 is the HCPCS code for “Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age…” in CMS’s October 2026 release, in effect from Oct 1, 2026.

Official description

G9862

Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is = 66 years old, or life expectancy < 10 years old, other medical reasons)

Short description: Doc rsn no 10 yr follow

HCPCS · United States

Medicare details

The indicators CMS publishes with G9862 in its October 2026 file. They describe Medicare’s handling, not another payer’s.

Medicare coverage
Carrier judgment
Medicare pricing
Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)
Type of service
Medical care
BETOS category
Undefined codes
Added
Jan 1, 2017

Where G9862 sits

  1. 1G codesProcedures and professional services
  2. 2Active code G9862Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is = 66 years old, or life expectancy < 10 years old, other medical reasons)

Source and release

Data release
HCPCS Level II · October 2026
Effective date
Oct 1, 2026
Publisher
CMS

This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.

Frequently asked questions

What does HCPCS code G9862 mean?

G9862 is the HCPCS code for “Documentation of medical reason(s) for not recommending at least a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is = 66 years old, or life expectancy < 10 years old, other medical reasons)” in CMS’s HCPCS Level II October 2026 release.

Does Medicare cover G9862?

CMS lists G9862’s Medicare coverage as “Carrier judgment” and its pricing as “Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.

Which HCPCS Level II release does this page use?

It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.